Screening, isolation: Key prison TB guidelines

Screening, containment, ongoing assessment

Infection control consultants working with correctional facilities should ensure that the following minimum measures are being done to control the transmission of tuberculosis, as recommended by the Atlanta-based Centers for Disease Control and Prevention’s Advisory Council on the Elimination of TB.1

• Screening. All correctional-facility employees and inmates who have suspected or confirmed TB disease should be identified promptly, and the cases should be reported to the health department. Employees and long-term inmates infected with TB (i.e., those who have positive skin-test results) should be identified and evaluated for preventive therapy.

• Containment. Persons suspected of having infectious TB disease should be placed immediately in an appropriate TB isolation room. A thorough contact investigation should be implemented promptly. Persons who have suspected or confirmed TB disease should promptly begin an adequate treatment regimen. Appropriate diagnostic, treatment, and laboratory services should be available. All therapy for TB disease should be directly observed.

• Assessment. Evaluation should include the collection and analysis of data to monitor whether the following activities are being implemented successfully:

— Cases of active TB disease are detected.

— Persons who have latent TB infection are identified and evaluated.

— Cases of TB disease are promptly reported, counted, and recorded.

— Persons who begin therapy for active TB disease or latent TB infection complete a recommended course of therapy.

— Referrals to other correctional facilities or to health departments are made and confirmed in a timely manner.

Reference

1. Centers for Disease Control and Prevention. Prevention and control of tuberculosis in correctional facilities: Recommendations of the Advisory Committee for the Elimination of Tuberculosis. MMWR 1996; 45(No.RR-8) 1-27.